Forging ties with China only adds to disease risk

By Twu Shiing-jer 涂醒哲

After the Chinese Nationalist Party (KMT) government in China was crushed by the communists due to internal corruption and was forced to retreat to Taiwan, it brought with it all kinds of infectious diseases.

In 1942, during the period of Japanese rule, there was only one case of smallpox in the nation and this person did not die of the disease. By contrast, in 1946, after the KMT occupied Taiwan, there was a smallpox outbreak, with 1,561 cases and 315 fatalities. By the following year, the disease had spread, bringing the total number of reported cases to 5,193, with 1,725 deaths.

It was the same with cholera. Efforts to fight the disease under Japanese rule managed to contain it to only the odd case every year from 1920. For example, in 1942 there were only seven reported cases, none of which were fatal. In 1946, 3,809 people were infected with cholera and 2,210 people died, a fatality rate as high as 58 percent.

The plague was no different. There had been no cases of plague in Taiwan since 1918, and yet when the KMT crossed the Taiwan Strait it brought the plague with it. In 1946, there were 14 cases of the disease, the first seen in Taiwan in 30 years. Four of those infected later died.

Of all infectious diseases, perhaps the most worrying are tuberculosis and malaria. Again, in 1946, there was a surge in deaths from tuberculosis and the infection rate of malaria also increased significantly compared with the period of Japanese rule.

When the KMT returned to power in 2008, President Ma Ying-jeou (馬英九) embarked on very pro-China policies and this accompanied another increase in the number of cases of infectious diseases imported into Taiwan.

For example, the only case of H7N9 avian flu reported outside of China was in Taiwan. Also, due to the Ma administration’s “diplomatic truce” with China, the rest of the world thought that Taiwan was an H7N9 virus epidemic area.

Then there is rabies. The nation was free of rabies in animals until it “retreated” to Taiwan from Shanghai in 1947. National Taiwan University Hospital first reported a case of rabies in a human in 1948 and the disease peaked in 1951 with 238 cases.

However, with the Taiwan Strait providing a natural barrier coupled with the success of efforts by the WHO and local authorities, rabies was eradicated in Taiwan by 1961, and the nation was listed as a rabies-free zone.

However, over the past few years there has been an increase in exchanges between Taiwan and China, and in 2002 a Chinese woman who had come to Taiwan developed the disease (rabies has a gestation period of three to eight weeks, perhaps longer).

Last year, when communication between the two nations was even closer, there was a case of a Taiwanese businessman who was bitten by a dog in China developing the disease on his return.

This was another case of a disease introduced from abroad. And now, Taiwanese find themselves with their very own “indigenous” case of rabies infection when an animal — a ferret-badger — bit a Taiwanese, and the nation is now listed as an epidemic area.

The H7N9 avian flu strain has also reappeared in China with cases of human-to-human transmission reported.

As Ma is not for changing course and is pursuing the ratification of a cross-strait service trade agreement, it is possible to foresee an increase in human-to-human and animal-to-human transmissions of diseases from China to Taiwan.